Background: First, work-related physical stressors and social disadvantage are associated with increased arthritis prevalence in high income countries (HIC); however, data is limited regarding arthritis in low-middle income countries. Second, childhood maltreatment (CM) has been shown to increase the risk of arthritis later in life, yet little is known about the impact of socioeconomic status in the onset of arthritis in those with CM history.
Methods: Study 1: Data were extracted from the from the World Health Organization’s Study on global AGEing and adult health (SAGE) Wave 1 (2007-10) for adults (n=21,389; 49.2% female; aged ≥50years) from Ghana, India, Russia and South Africa. Arthritis was identified using a symptom-defined algorithm and self-reported doctor-diagnosis. Occupational stressors were classified using a sex-specific Job Exposure Matrix. Study 2: Data were obtained from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC, USA, n=34,563; aged ≥20years) Wave 2 (2004-05). CM history was self-reported.
Results: Study 1: Significant associations were found between doctor-diagnosed arthritis and heavy physical work (adjusted odds ratios [AOR] 1.12, 95%CI 1.01-1.23), and between symptom-based arthritis and keeling or squatting (AOR 1.27, 95%CI 1.08-1.50), heavy lifting (AOR 1.33, 95%CI 1.11-1.58) and arm elevation (AOR 2.16, 95%CI 1.63-2.86). Study 2: In sex-stratified, age-adjusted analyses, CM was associated with arthritis but did not amplify the relationship between SES and arthritis.
Conclusions: Implications include minimizing occupational health risk factors in low-middle income countries and considering that a reduction in the burden of CM may also be considered a primary preventative measure of arthritis.